• Kyoung Min Lee, Chin Youb Chung, Soon-Sun Kwon, Myung Ki Chung, Sung Hun Won, Seung Yeol Lee, and Moon Seok Park.
• Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-Dong, Bundang-Gu, Sungnam, Kyungki, 463-707, South Korea.
• Skeletal Radiol. 2013 Nov 1; 42 (11): 1537-42.

ObjectiveThis study was performed to investigate the relationship between the injured lateral ankle ligaments on MRI and stress ankle radiographs.Materials And MethodsTwo hundred and twenty-nine consecutive patients (mean age 35.5 years, SD 14.6 years; 136 males and 93 females) that underwent ankle stress radiographs and MRI for lateral ankle instability were included. Tibiotalar tilt angle and anterior translation of talus were measured on stress ankle radiographs. Degree of lateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) and deltoid ligament injuries were evaluated and scored as intact (0), partial injury (1), and complete injury (2) on MR images. Effusion of ankle joint was also recorded. The effects of gender, age, injuries of ligaments, and ankle joint effusion on stress radiographs were statistically analyzed.ResultsGender (p = 0.010), age (p = 0.020), and anterior talofibular ligament (ATFL) injury (p < 0.001) were the factors significantly affecting tibiotalar tilt angle. Posterior talofibular ligament (PTFL) injury (p = 0.014) was found to be the only significant factor affecting the anterior translation on the anterior drawer radiographs.ConclusionsATFL injury and PTFL injury on MRI significantly affected tibiotalar tilt angle and anterior drawer on stress radiographs. Other factors, such as age and gender, need to be considered in evaluating radiographic lateral ankle instability.

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